The Lyme School •  Lyme, New Hampshire
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Policy Manual

Policy: JGCE-2
Administering Medication in Schools

Whenever possible, a student’s medical needs should be met outside the school. However, if a student is required to take medication during the school day, the administration of such medication shall comply with the following guidelines.

A. General Guidelines

The following shall apply to the administration of both prescription and non-prescription medication in school:

1. The school nurse shall be notified of all prescription and non-prescription medications to be used during school and/or school activities.

2. No medication shall be administered to any student unless the principal and the school nurse determine that the school has the capacity to administer the drug safely and address any possible side effects should they occur.

3. Records shall be kept of all prescription and non-prescription medications administered in school.

4. No student shall have prescription or non-prescription medication on his/her person during the school day, with the exception of inhalers for respiratory concerns and epinephrine auto-injectors in case of severe allergy, provided the school nurse has prior written permission from the student’s parent/legal guardian and physician. Unique individual circumstances will be addressed in consultation with the parent/guardian and the student’s physician.

5. Students shall not share prescription or non-prescription medication with other students.

6. The school nurse and school principal, in conjunction with the parent/guardian, may make arrangements to have the medication administered to the student in situations during which the school nurse cannot be present.

7. If an adult other than the school nurse is required to administer the medication, training this individual shall be the responsibility of the parent/guardian, and the parent/guardian shall certify that appropriate training has occurred.

B. Prescription Medication
The following shall apply to the administration of prescription medication in school:

1. A student who is required to take, during the school day, medication prescribed by a licensed physician, advanced registered nurse practitioner, licensed physician’s assistant, or dentist, shall have the school nurse either administer the medication or assist the student in taking the medication. However, the school nurse may delegate the administration of medication to others, if appropriate, pursuant to RSA 326-B Nurse Practice Act and Nur 404.

2. A student with chronic illnesses (e.g., asthma, seizure disorders, cystic fibrosis, diabetes, etc.), who is capable of administering medication to himself/herself, may be allowed to do so with the permission of the parent/guardian and physician, and under the supervision of the school nurse.

3. The school nurse shall ensure that a written statement from the licensed prescriber is in the student's health record containing the following:
a. The student's name;
b. The name and signature of the licensed prescriber and contact numbers;
c. The name, route and dosage of medication;
d. The frequency and time of medication administration or assistance;
e. The date of the order; and
f. The student’s diagnosis, if not a violation of confidentiality;

The order may be faxed to the school, but an original copy of the order must be produced within 24 hours of receipt of the faxed copy. Note that a pharmacy label does not constitute a written order and cannot be used in lieu of a written order from a licensed prescriber.

4. Upon receiving a request from a student’s parent/guardian, physician, or other medical practitioner regarding the student's need for medication during school hours, the school nurse may contact the parent/guardian to discuss whether the student should remain at home, or whether the medication should be taken before, during, and/or after school. The nurse may also inquire about any other medical conditions requiring medications and any side effects, contraindications, and adverse reactions to be observed.

5. The school nurse shall ensure that there is written authorization by the parent/guardian for the administration of the medication in school, which contains:
a. The parent/guardian's printed name and signature;
b. A list of all medications the student is currently taking, if not a violation of confidentiality or contrary to the request of the parent/guardian and/or student;
c. The parent/guardian's home and emergency telephone number(s); and
d. The names of persons to be notified in case of a medication emergency, in addition to the parent/guardian and licensed prescriber.

6. The parent/guardian is responsible for having the medication delivered by a responsible adult directly to the office of the school nurse. The medication must be brought to school in a container appropriately labeled by the pharmacy or physician with the student's name, physician's name, date of original prescription, expiration date, name and strength of medication, and indications and directions for administration.

7. The parent/guardian is responsible for ensuring the student’s medication is up-to-date.

8. Non-emergency medication shall be kept in the school nurse's office in a locked cabinet or refrigerator unless otherwise indicated. No more than a 30-day supply shall be kept and maintained by the school. Emergency medication may be secured in other locations readily accessible only to those with authorization.

9. Unused medication shall be returned to the parent/guardian.

10. The school nurse may administer a physician-ordered off-label medication (an FDA-approved medication prescribed for an indication for which it has not been approved) to a student if all the above conditions apply and:
a. The school has a physician-signed medical order for the administration of the off-label medication that specifies the dose, route, and conditions under which the off-label medication is to be given;
b. The student’s physician has provided a specific procedure to guide the safe administration of the off-label medication to the child. This will include indications, directions for preparation of the medication for administration, supplies necessary for administration, conditions necessary for the storage of the medication, and information about possible side effects; and
c. The student’s parent/guardian has given signed permission to the school nurse to have the medication administered to the student.

C. Non-Prescription Medication

The following shall apply to the administration of non-prescription medication in school:

27. Written permission from the parent/guardian must be provided if a non-prescription/over-the-counter medication is to be used during school hours or activities.

28. Non-prescription medication must be brought to school in a properly labeled container, in original packaging, and must be left in the nurse's office .


Legal References:
NH Code of Administrative Rules, Section Ed 311.02, Medication During the School Day.


ADOPTED: 19 November 1992
REVISED: 8 December 1994; 18 November 2010